Objective To investigate the relationships between serum procalcitonin (PCT) level and APACHE Ⅱ score as well the prognosis of septic patients.Methods Ninety patients with sepsis were collected from emergency and critical care department of Third Hospital,Peking University,Beijing.Within 24 hours after admission,the serum PCT,hypersensitive C-reactive protein (hs-CRP),leucocyte count (WBC) and lactic acid were examined,and APACHE Ⅱ score were calculated.According to APACHE Ⅱscore,the septic patients were divided into three groups of high,median and low scores.Based on the 28 -day outcomes of patients,the patients were divided into survival group and death group.The differences in PCT,APACHE score,WBC and lactic acid between the survival group and the death group were detected.Results The serum levels of PCT were significantly higher ( P ＜ 0.01 ) in patients with high APACHE Ⅱ score ( ＞ 20) than that in patients with median score (10-20) and low score ( ＜ 10 ).There was significant correlation between PCT level and APACHE Ⅱscore ( r =0.58,P ＜0.01 ).Conclusions There is a good correlation between serum PCT level and APACHE Ⅱ score.The serum PCT and APACHE Ⅱ can be used for predicting the outcomes of septic patients.

Objective To investigate the effect of Xinmailong injection combined with Qiliqiangxin capsule on serum BNP , NF-kappa B and cystatin C in the treatment of chronic heart failure in the elderly .Methods 78 cases of elderly patients with chronic heart failure were selected and randomly divided into two groups according to the random number table, 39 cases in each group.All patients received basic treatment, the control group received standard treatment, and the study group received more with Xinmailong injection combined with Qiliqiangxin capsule,and levels of serum B-type natriuretic peptide(BNP), cystatin C(CysC) and NF-κB were compared, left ventricular function and 6 min walking test were detected and the clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of serum BNP, CysC and NF-κB in 2 groups decreased(P<0.01), left ventricular ejection fraction(LVEF) increased(P<0.05), left ventricular end-systolic volume(LVESV) reduced(P<0.05), 6 min walking distance increased(P<0.01), scores of symptom decreased(P<0.01), compared with the control group, levels of serum BNP, CysC and NF-κB in study group were lower, LVEF were higher ( P<0.05 ) , levels of LVEDV and LVESV were lower ( P<0.05 ) , scores of 6 min walking distance were higher(P<0.01), scores of symptom were lower (P<0.01), the effective rate was higher(P<0.05).Conclusion Xinmailong injection combined with Qiliqiangxin capsule in the treatment of chronic heart failure in the elderly was effective , and it can improve left ventricular function, the possible mechanism related to the decrease of BNP, CysC and NF-κB levels.

Objective To explore the effects of multi-position lower limb rehabilitation robot on motor function in hemiplegia patients after stroke. Methods 40 stroke patients with hemiplegia were randomly divided into control group and observation group, with 20 cases in each group. Both groups received conventional rehabilitation training, and the observation group received multi-position lower limb rehabilitation robot training, 20 min a day. Berg balance scale (BBS), Fugl-Meyer assessment (FMA), modified Barthel index (MBI), Functional Ambulation Category (FAC), 10 minutes maximum walking speed and modified Ashworth scale (MAS) were used to evaluat the outcome.Results The scores of BBS, FMA and MBI increased after treatment in both groups (P<0.05), and the score was more in the observation group than in the control group (P<0.01). The FAC and 10 minutes maximum waking speed were better, and the score of MAS was lower in the observation group than in the control group after treatment (P<0.01). Conclusion Multi-position lower limb rehabilitation robot is effective on the motor function and balance function of stroke patients with hemiplegia.

Objective To investigate the change in blood lymphocyte levels and lymphocyte percentage in critical patients,including those with non-infectious systemic inflammatory response syndrome (SIRS),sepsis and severe sepsis.Methods Clinical data of 423 patients admitted to intensive care unit (ICU) of Department of Emergency of Peking University Third Hospital from January 2011 to September 2013 were retrospectively analyzed.Among these patients,there were 54 with non-infectious SIRS,177 with sepsis and 192 with severe sepsis.150 of them died,and 273 survived.The white blood count (WBC),neutrophil (N),lymphocyte count,lymphocyte percentage,lactic acid,serum high-sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined at admission,and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was estimated.The patients were divided into different groups according to diagnosis and prognosis to compare the value of the indexes,and the correlation between lymphocyte count and other markers were analyzed by Spearman relative analysis.Results The older the patients,the more severe the disease.In the non-infective SIRS,sepsis and severe sepsis groups,APACHE Ⅱ scores (7.78 ± 3.72,13.85 ± 7.22,24.00 ± 9.79),time of stay in hospital [days:6.0 (1.0,9.0),12.0 (8.0,22.0),19.5 (7.0,29.0)],the mortality rate (0,10.2％,52.6％),WBC (× 109/L:7.59 ± 3.27,8.94 ± 3.95,10.32 ± 5.50),N (0.685 ± 0.132,0.778 ± 0.135,0.831 ±0.086),hs-CRP [mg/L:4.60 (2.80,7.52),23.58 (13.49,49.22),59.77 (19.36,110.62)] andPCT [μg/L:0.05 (0.05,0.05),0.09 (0.05,0.61),0.63 (0.10,5.25)] showed gradually increasing tendency (all P=0.000).Serum lymphocyte count levels [× 109/L:1.53 (0.89,1.88),0.90 (0.65,1.42) and 0.80 (0.50,1.12)],lymphocyte percentage (0.225 ± 0.122,0.138 ± 0.097,0.106 ± 0.070) showed gradually decreasing tendency (P＜0.05 or P＜0.01).There was significant difference in blood lactic acid among three groups [blood lactic acid were 2.40 (1.30,5.10),1.10 (0.80,2.00) and 1.40 (1.00,2.50) mmol/L in the non-infective SIRS,sepsis and severe sepsis groups respectively,P=0.000].Age (years old:76.71 ± 12.21 vs.73.21 ± 14.49),APACHE Ⅱ score (24.69 ± 9.58 vs.13.91 ± 8.41),time of stay in hospital [days:12.0 (4.0,28.0) vs.11.0 (8.0,22.0)],WBC (× 109/L:10.29 ± 5.82 vs.8.89 ± 3.98),N (0.809 ± 0.130 vs.0.776 ± 0.120),lactic acid [mmol/L:1.80 (1.10,2.90) vs.1.30 (0.90,2.49)],hs-CRP [mg/L:50.94 (19.21,97.13) vs.21.71 (6.39,54.40)] and PCT [μg/L:0.74 (0.13,5.83) vs.0.08 (0.05,0.59)] levels in the death group were higher than those in the survival group (P＜0.05 or P＜0.01),serum lymphocyte count levels [× 109/L:0.90 (0.50,1.29) vs.1.05 (0.70,1.54)],lymphocyte percentage (0.123 ± 0.098 vs.0.143 ± 0.097) level in the death group were obviously lower than those in the survival group (P＜0.01 and P＜0.05).Serum lymphocyte count levels were negative correlated with N (r=-0.597,P=0.000),hs-CRP (r=-0.298,P=0.000),PCT (r=-0.304,P=0.000),APACHE Ⅱ (r=-0.124,P=0.000),and positively correlated with lymphocyte percentage (r=0.691,P=0.000),and non correlations was found with WBC (r=0.082,P=0.091) and lactic acid (r=0.073,P=0.132).Conclusion The serum lymphocyte levels in the critically ill patients are related with the severity of sepsis,and monitoring the change in lymphocyte may be an indicator for evaluating the illness and effect of treatment.

Objective To investigate the difference in the incidence of postextubation throat complications between severe patients treated with methylprednisolone intravenously with and without budesonide suspension inhalation immediately after postextubation.Methods 75 patients with tracheal intubation were divided into group A (n=36,patients received methylprednisolone 40 mg intravenously before extubation) and group B (n=39,patients received methylprednisolone 40 mg intravenously before extubation and budesonide suspension inhalation 1 mg immediately after extubation).Postextubation thoat complications including sore throat,hoarseness and laryngeal edema were observed in the two groups.Clinical efficacies in the two groups were analyzed.Results The incidences of sore throat,hoarseness and laryngeal edema after extubation were 50.0％ (18/ 36),55.6％ (20/36) and 5.6％ (2/36) respectively in group A and 30.8％ (12/39),35.7％ (14/ 39) and 2.6％ (1/39) respectively in group B.There were no significant differences in the incidences of sore throat,hoarseness and laryngeal edema after extubation between the two groups,but the tendencies of complication incidences were decreased in group B as compared with group A.Conclusions The application of intravenous methylprednisolone before extubation and budesonide suspension inhalation after extubation can reduce the incidences of sore throat,hoarseness and laryngeal edema after extubation.

0.05). Conclusion The study of the characteristic of track of percutaneous transpedicular puncture is good for the safe procdure under image guidance. The standard track is safe for transpedicular or parapedicular puncture. The percutaneous transpedicular puncturing sites can be located according to the spinous process.

Objective To investigate the asthma and the risk factors in the greenhouse-vegetable planter in Tangshan, Hebei province. Methods 1604 planter were chosen by cluster sampling and were investigated by questionnaire according to the standard of Chinese Medical Asthma Association (2003) during Jan.-June, 2006. Results 42 asthma patients were diagnosed, the prevalence rate was 2.62%, 1.78% in the male and 3.42% in the female. The family history, history of allergic diseases, upper respiratory path infection, smoking, kind of plant, pets were the risk factors. Conclusion The prevalence of asthma in the greenhouse-vegetable planters in Tangshan is related to the family history, history of allergic diseases, upper respiratory path infection, smoking, kind of plant, breed pets and working time.

Objective To probe the effects of the size and location of cranial defect on the neurological symptoms of patients with skull bone defect.Methods The patients were classified into the following groups according to the influence to symptoms by changes in body position and changes of symptoms before and after craniectomy: True syndrome of the trephined(ST,Ⅰ), partial ST patients(Ⅱ), other patients or symptom-free patients (Ⅲ).Results The group I consisted of 33 cases, their defects were located in the parieto-occipital region in 23 cases, frontoparietal in 10 cases. All these patients had flaccid skin flaps that became concave while in the upright position. The group Ⅱ was composed of seven cases, their defects were located in frontoparietal and parieto-occipital region in three respectively. All these patients had flaccied skinflap in defects pars.Group Ⅲ included twelve patients, flat and rigid skin flaps were usually demonstrated , predominantly in the tempora and parietal regions.Conclusions The size and location of the cranial could play an important role in the development of the neurological symptoms.

Objective To explore the optimal pedaling rate in bicycle ergometer exercise. Methods 19 healthy men mean aged 22.8years were instructed to pedal a bicycle ergometer, and their reaction time were measured in pedaling rate of 20 r/min, 40 r/min, 60 r/min, 80r/min, and 100 r/min under the workload of 40 W, 60 W, 80 W, 100 W, and 120 W, respectively. The minimum reaction time was probedwith polynomial regression analysis. Results The minimum probe reaction time was reckoned at 63.5 r/min at 40 W, 58.8 r/min at 60 W,61.3 r/min at 80 W, 63.4 r/min at 100 W, 64.8 r/min at 120 W. Conclusion The optimal pedaling rate was approximately 60 r/min regardlessof workload.

This paper introduces chief physician LIU Huilin's empirical characteristics in treating cluster headache based on holism and pattern-identification-based treatment,with spirit-regulating filiform needling,filiform fire needle pricking,and collateral-pricking for bloodletting sequential therapy,which inherits the academic thoughts of"acupuncture-moxibustion for treating spirit"from Professor ZHOU De'an and"three-unblocking acupuncture therapy"from HE Puren,thus providing a reference for treating cluster headache with acupuncture-moxibustion therapy.